Fractional ablation with a CO2 laser
As we age, our skin loses its fresh and smooth appearance because we lose collagen, develop areas of hyperpigmentation from sun exposure, and form wrinkles and creases. Today more people than ever are avoiding invasive procedures like the facelift because there are effective non-surgical options that allow them to return to work quickly with little downtime and discomfort. Fractional ablation with a CO2 laser uses energy in the form of heat to precisely remove layers of damaged skin, which can be used to treat sun damage, fine and deep wrinkles, scars, and skin lesions.
CoolPeel® is a brand new way to safely, and comfortably deliver the benefits of a traditional CO2 resurfacing treatment. By targeting just the superficial layer of skin tissue, damaged skin is removed using heat, revealing younger and healthier looking skin. Many advances have been made to improve the side effects of CO2 treatments but ONLY the CoolPeel® can deliver a fractional ablative treatment without the downtime. There is minimal risk of hyperpigmentation, demarcation or induced infection.
How does a CO2 laser work?
Lasers used in aesthetics can have a variety of applications with the CO2 laser serving as one of the most widely used because its wavelength is well absorbed in water (also known as the chromophore). As skin contains a very high percentage of water, this makes the CO2 laser ideal for precise, safe ablation with good hemostasis or control of bleeding. When lasers are used for aesthetic purposes, we use laser energy to ablate or vaporize tissue while minimizing damage to the surrounding tissue.
Fully ablative treatment with a CO2 laser involves removal of the entire epidermis, which stimulates the regrowth of a younger-looking epidermis, collagenesis and remodeling of the dermis. The aim of fully ablative resurfacing is to ablate the epidermis cleanly off the dermis and leave a zone of dermis that would promote the wound healing process, which gives great results but comes with significant discomfort and downtime, as well as the risk of infection and scarring.
Fractional ablation is a newer approach that uses microablative columns of vaporization involving both the epidermis and dermis, which stimulates re-epithelialization in the normal surrounding undamaged skin and wound healing under the protection of an intact epidermis to give similar results to full ablation without the discomfort, downtime or risk of complications.
Nonablative methods are not considered as effective as the ablative methods because they leave the epidermis intact, limiting the healing response.
Click here to read a review article about CO2 laser treatments
What conditions can be treated with a CO2 laser?
Fractional ablation with a CO2 laser can be used to treat the following conditions:
- Sun damage including freckles, sun spots, and hyperpigmentation
- Fine and deep wrinkles
- Acne and acne scars
- Skin laxity and uneven texture
- Scars
- Large pores
- Stretch marks
Fractional ablation can also be performed on body parts other than the face, including the neck, decolletage, chest, arms and hands for skin rejuvenation.
Can CO2 laser treatments be performed on any Fitzpatrick skin type?
We offer two primary types of fractional ablation with a CO2 laser at Studio R Aesthetics, with the primary difference being how deep we perform the ablation.
The Coolpeel treatment is limited to the epidermal layer and does not reach the epidermal-dermal junction, where the melanocytes are found. Because we are limiting treatment to the epidermis, the Coolpeel can be performed on any skin type with minimal risk of postinflammatory hyperpigmentation. Downtime is minimal and patients typically look like they have a sunburn with rough skin for 2-3 days.
The Deka treatment goes deeper into the dermis, beyond the epidermal-dermal junction. This treatment can only be performed on Fitzpatrick I-III patients because of the risk of PIH in patients with a higher Fitzpatrick type. Patients typically experience seeping and skin crusting for up to 10 days after more aggressive treatments.
Is treatment with a CO2 laser painful?
At Studio R Aesthetics, we ensure that our patients have access to treatments without fear of intolerable discomfort. We can apply the strongest topical anesthetic available to the treatment site for at least 30 minutes prior to performing the procedure, which desensitizes the nerve endings in the epidermis and reduces sensations from a CO2 laser treatment.
We can use a Chiller device to blow cold air at -30 degrees on the treatment area, which further desensitizes the nerve endings and reduces pain. Pronox cannot be used during laser treatments due to the risk of fire.
Are there any side effects or complications related to a CO2 laser treatment?
There are both risks and complications associated with all laser treatment procedures of the skin.
Infection: Although infection following laser skin treatment is unusual, bacterial, fungal, and viral infections can occur. Herpes simplex virus infections around the mouth or other areas of the face can occur following a more aggressive laser treatment. This applies to both individuals with a past history of Herpes simplex virus infections and individuals with no known history of Herpes simplex virus infections in the mouth area. We typically prescribe valacyclovir prior to aggressive fractional ablation treatments.
Scarring: Although normal healing after the procedure is expected, abnormal scars may occur both in the skin and deeper tissues. In rare cases, keloid scars may result. To minimize the chances of scarring, it is critical that all patients follow the post-treatment instructions provided by our staff.
Burns: Laser energy can produce burns. Burns are rare yet represent the effect of heat produced within the tissues by laser energy. Additional treatment may be necessary to treat laser burns.
Redness/Swelling/Bruising: Redness (erythema) or swelling (edema) of the treated area is common and may occur. There also may be some bruising.
Color Change: During the healing process, there is a slight possibility that the treated area may become either lighter (hypopigmentation) or darker (hyperpigmentation) in color compared to the surrounding skin. This is usually temporary, but, on a rare occasion, it may be permanent.
How does fractional ablation work?
Dr. Itri introduces the Coolpeel laser
CO2 Laser Ablation FAQs
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